DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20201338

Serum uric acid as a prognostic indicator in acute ischemic stroke

Chandana Kaspa, Shankar Govindu

Abstract


Background: Association between serum uric acid (SUA) and the outcome of acute ischemic stroke is debated and needs to be evaluated. The present study was conducted to study the serum uric acid concentration as an indicator of   outcome among acute ischaemic stroke and to determine the role of serum uric acid as a risk factor for acute ischemic stroke.

Methods: An observational study where 50 patients who presented within 48 hours of onset of stroke admitted to medical wards of government general Hospital Guntur were selected for the study.

Results: Out of 50 patients included for the study, 6 belonged to the age group of 30-40 years. Majority were male (66%) and 44.5% of the males and 76.5% of females showed raised serum uric acid levels. 25 out of 50 patients were diabetic (i.e. 50%) Among them 16 had serum uric acid >6 mg% (ie.64%), 56% of the patients were hypertensive and among them 71% were found to have uric acid levels greater than 6mgs%, 38 out of 50 patients had bad outcome, with elevated uric acid levels found 30 among them. In the present study, BMI and outcome of Stroke were significantly associated with Serum Uric acid levels.

Conclusions: Serum uric acid levels can be used as a prognostic indicator as a marker for increased risk of stroke. Elevated serum urate concentration may stratify risk of death after acute stroke.


Keywords


Ischemic stroke, Prognosis, Serum uric acid

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References


Hatano S. Experience from a multicentre stroke register: a preliminary report. Bull World Health Organ. 1976;54(5):541-53.

Caplan LR. Caplan's Stroke: A Clinical Approach. Basic pathology, anatomy, and pathophysiology of stroke. 4th ed. Philadelphia: Saunders Elsevier; 2009:22.

Chugh C. Acute Ischemic Stroke: Management Approach. Indian J Crit Care Med. 2019;23(Suppl 2):S140-6.

Fang J, Alderman MH. Serum Uric Acid and Cardiovascular Mortality: The NHANES I Epidemiologic Follow-up Study, 1971-1992. JAMA. 2000;283(18):2404-10.

Love S. Oxidative stress in brain ischemia. Brain Pathol Zurich Switz.1999;9(1):119-31.

Kaur I, Khurana A, Sachdev JK, Mohan G. Evaluation of serum uric acid in acute ischaemic stroke. Int J Adv Med. 2017;4:60-5.

Álvarez-Lario B, Macarrón-Vicente J. Uric acid and evolution. Rheumatol. 2010;49:2010-5.

Waring WS. Uric acid: an important antioxidant in acute ischaemic stroke. QJM. 2002;95:691-3.

Chamorro Á, Obach V, Cervera Á, Revilla M, Deulofeu R, Aponte JH. Prognostic significance of uric acid serum concentration in patients with acute ischemic stroke. Stroke. 2002 Apr 1;33(4):1048-52.

Niskanen LK, Laaksonen DE, Nyyssonen K, Alfthan G, Lakka HM, Lakka TA, et al. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med. 2004;164:1546-51.

Santos CX, Anjos EI, Augusto O. Uric acid oxidation by peroxynitrite: multiple reactions, free radical formation, and amplification of lipid oxidation. Arch Biochem Biophys. 1999;372:85-294.

Abuja PM. Ascorbate prevents prooxidant effects of urate in oxidation of human low density lipoprotein. FEBS Lett. 1999;446:305-8.

Griendling KK, Sorescu D, Ushio-Fukai M. NAD(P)H oxidase: role in cardiovascular biology and disease. Circ Res. 2000;86:494-501.

Bedir A, Topbas M, Tanyeri F, Alvur M, Arik N. Leptin might be a regulator of serum uric acid concentrations in humans. Jpn Heart J. 2003;44:527-36.

Cheng W, Wen S, Wang Y, Qian Z, Tan Y, Li H, et al. The association between serum uric acid and blood pressure in different age groups in a healthy Chinese cohort. Med. 2017 Dec;96(50).

Buzas R, Tautu OF, Dorobantu M, Ivan V, Lighezan D. Serum uric acid and arterial hypertension-Data from Sephar III survey. PloS one. 2018;13(7).

Honggang WA, Lizhen WA, Rui XI, Weijie DA, Chengcheng GA, Peng SH, et al. Association of serum uric acid with body mass index: a cross-sectional study from Jiangsu Province, China. Iran J Public Health. 2014 Nov;43(11):1503-9.

Kaur I, Khurana A, Sachdev JK, Mohan G. Evaluation of serum uric acid in acuteischaemic stroke. Int J Adv Med. 2017;4:60-5.

Prasad CP, Dwivedi NC, Gupta P, Shukla SK, Shukla R, Yadav RK, et al. Serum uricacid level in patients of acute stroke. Int J Adv Med. 2016;3:393-7.